Vet Pages
Southern Oregon Veterinarian Specialty Center’s
SPRING | 2013
Welcome Back Dr. Hoots!
The partners and staff at Southern Oregon Veterinary Specialty Center are
pleased to announce the return of surgeon, Dr. Eric Hoots, MS, DipACVS, to our
hospital beginning Wednesday, May 8, 2013.
Many of you may remember Dr. Hoots as a member of our surgery team
until 2010, when he left to accept a position at a specialty hospital, closer to
his family, in Albuquerque, New Mexico. We are excited to have him rejoin the
Southern Oregon veterinary community!
THIS ISSUE
2 CASE
STUDY - THE CASE OF
THE ABSCESS IMPERSONATOR
By Kimberly Winters, DipACVIM,
Internal Medicine
Steve Ferreira,
DipACVS,
Surgery
With Brodie
Kimberly Winters,
DipACVIM,
Internal Medicine
With Darby
Adam Reiss, DipACVECC
Emergency & Critical Care
With Tater
Diana Schropp, DipACVECC,
Emergency & Critical Care
With Magoo
3 practice manager earns tOP DOG AT SOVSC
4 Earn ce credit
Journal Club Is Now Rogue Valley
Veterinary Round Table
4 upcoming ROUND TABLE
articles
Expanded Surgical Schedule
We have expanded our surgical schedule to allow you to make
appointments with Dr. Hoots or Dr. Ferreira, Monday through
Saturday. Contact our office to schedule an appointment:
541-282-7711
sovsc
C ASE STUDY:
The Case of the Abscess Impersonator
By: KIMBERLY WINTERS, Dip, acvim
internal medicine
Sam, an 11 year old CM DSH initially presented
for evaluation of a bleeding wound that the cat had
reportedly sustained about 2 weeks previously. The
owner had cleaned and applied antiseptic to the
wound. It seemed to heal but began to ooze again. He is an indoor/outdoor cat and has been wounded in
fights before.
At presentation, Sam had an approximate 3x3cm
firm soft tissue swelling of the abdomen, apparently
associated with left ventral fat pad. The area was
described as a wound with palpable SQ emphysema
that was oozing serosanguinous, purulent discharge. The skin was purple at the center and yellow along
the edges of the swelling with moderate associated
ecchymosis.
He was treated for suspected steatitis of the
fat pad with cleaning, an e-collar, Convenia and buprenorphine. Recheck in 3 days was recommended.
He represented the next day due to decreased
appetite. He had visited his regular veterinarian
where he was found to be moderately anemic (PCV
- 16%) with normal WBC, platelet count, and serum
chemistries. He was pale and tachycardic and the
ventral abdominal abnormality was described as a
plaque-like mass with associated dependent bruising. He was found to have prolonged PT (24s) and
PTT (>300). Abdominal ultrasound was unremarkable
and ultrasound of the mass revealed cavitations with
surrounding hyperechoic fat. Cytology of the mass was
consistent with hematoma. Full clotting profile and
Cryptococcus titer were submitted to outside labs. Sam was treated with buprenorphine, clavamox
and fresh whole blood for pain, potential bacterial infection, and replacement of clotting factors and red
blood cells, respectively. Differentials included hemophilia and DIC secondary to infection, severe inflammation, or neoplasia. Sam’s Cryptococcus antigen titer was negative
and clotting profile revealed normal factors VIII and
IX, extremely elevated d-dimer (2346 (0-250)) and
elevated APTT (29.4 (14-18s)), PT (24.7 (14-22s)),
and thrombin clotting time (20s (5-8s)). Sam’s clotting abnormalities were consistent with hypofibrinogenemia and DIC. The
owner and I discussed
cutaneous hemangiosarcoma as the most likely
differential
diagnosis
but severe steatitis was
also possible. Surgical
resection and histopathology evaluation were
recommended. Sam’s PCV/TS was
stable and bleeding did
not recur for 3 days
when he again began to
hemorrhage from the
abdominal skin mass. He was lethargic, pale, tachycardic, and tachypneic. The abdominal plaque-like
mass was actively bleeding and he was bleeding from
a 2 day old venipuncture site. He also had extensive
ecchymosis of the cranial abdominal skin.
Fresh frozen plasma and fresh whole blood were
administered and the mass (skin and SQ) was resected
with a 1.5cm margin around the grossly abnormal tissue. The SQ fat was removed to the level of the body
wall fascia. Sam’s clotting times resolved post-operatively. PT was >100 and PTT was >300 after plasma
and whole blood transfusions the day of surgery and
normalized by the morning after surgery (PT 15 and
PTT 67). Sam recovered uneventfully and histopathology revealed hemangiosarcoma throughout the
skin and SQ tissues. Cancer cells extended to the
margins of the resected tissues. This case is interesting in several respects. The
initial “wound” that the owner noted was most likely
a SQ mass that had ruptured and subsequently healed. Cutaneous and subcutaneous HSA is not a common tumor in the feline, accounting for less than 2% of nonhematopoietic tumors. Complete surgical resection
She graduated from Oregon State University with a
Bachelor’s in Animal Science. Shortly after college,
Kay spent a couple of years training hearing service
dogs at Dogs for the Deaf.
In 1983, Kay began working at the Siskiyou Vet
In 2010, Kay Boydston joined the Southern Or- erinary Hospital, where she stayed for over 25 years. egon Veterinary Specialty Center team. Her years of She was instrumental in coordinating 15 local veteriexperience working in the veterinary field make her a
perfect fit for her position as an Administrative Aide. Kay provides support to team members in all areas of
administration and management.
"Kay has many years of experience in veterinary
administration and outreach to the Rogue Valley pet
community. We feel so lucky to have her on our team,"
says Dr. Diana Schropp.
"I truly enjoy working at SOVSC," Kay states.
"SOVSC runs the hospital with a team of managers,
who work together exceptionally smoothly. Our staff
members are strategically placed in positions that
complement their strengths."
Kay has always had a love of animals and knew in
Kay & Silver
high school, working with horses in her 4-H club, that
she wanted to pursue a career that involved animals. narians for after-hours emergency rotation, as there
was no 24-hour animal hospital in Southern Oregon at
Case Study Continued
is recommended if possible, as surgical resection is the time.
Working with animals is not Kay's only passion,
associated with longer disease free interval and sur- she
also
loves to play with them. Over the past couvival. SQ HSA is oftentimes difficult to fully resect
due to the locally aggressive nature of the tumor and ple of decades, Kay has trained and competed with
in Sam’s case, the owner declined further resection many of her dogs in canine agility. Canine agility
since the body wall would need to be partially resect- requires the dog to run a course that includes tuned and would not necessarily remove all microscopic nels, jumps, a-frames and teeter totters. She also enjoys dock diving, a sport in which dogs leap in to the
disease. Post-operative chemotherapy with doxorubicin is water, where the objective is to jump the furthest
recommended due to inevitable local recurrence with distance. n 1995, Kay and Lynell Dewey, founded the
both complete and incomplete resections and mod- Rogue Canine Agility club. The club helps dog owners
erate metastatic potential. There are not statistics learn about the sport and engages the public in finddescribing survival and disease free intervals in cats ing out more about canine agility. Kay has served as
that are treated with post-operative chemotherapy, a board member and Chief Instructor for the club for
many years.
however. Silver, her blue merle Australian Shepherd that
Reported survival times with surgery alone (even with incomplete resection) are close to a year with Kay raised from a 7-week-old pup, loved dock diving.
some cats surviving longer than 2 years. Survival is "Silver was my 'heart dog.' She was crazy for tennis
statistically longer with complete resection and tu- balls and swimming, so she took to dock diving with
mors are reported to recur locally anywhere from enthusiasm," says Kay. Sadly, Kay recently said goodbye to Silver when she passed on at the age of 13.
1month - 2yrs post-operatively.
Kay supports the Southern Oregon Humane So
Sam presented in DIC. DIC can occur second- ciety
and other organizations in our community that
ary to severe infection, inflammation, and certain
neoplasms such as hemangiosarcoma. Sam’s active care for animals and has stayed true to her life’s misbleeding temporarily responded to whole blood and sion of working with animals.
“Kay is dedicated to the local veterinary complasma transfusions even though clotting times never normalized but DIC did not resolve until the HSA was munity which she has been a part of for many years,”
resected and it resolved almost immediately, post- says Dr. Cheryl Croley. Her vast experience, positive
outlook, and cheerful personality make others feel
operatively. comfortable.”
TOP DOG AT SOVSC
Journal Club Is Now
Rogue Valley
Veterinary Round Table
Earn 2 Hours Of CE Credit
Wednesday, May 22nd
7 p.m. - 9 p.m.
Southern Oregon Brewing Co.
1922 United Way, Medford
(Reserved Exclusively for SOVSC’s
RV Vet Round Table Discussion)
Wings, Beer and Non-alcoholic
Beverages Provided
Moderated By:
Dr. Eric Hoots, MS, DipACVS
RSVP:
Call To Reserve A Spot
541-282-7711
(space is limited)
And Obtain A Copy
Of The Articles
3265 Biddle Road, Medford, OR 97504
541-282-7711 Fax 541-282-7999
www.sovsc.com
Have You Heard?
Journal Club Is Now
ROGUE VALLEY
VETERINARY ROUND TABLE
CE Credit Available!
This round table discussion will be lead by one of SOVSC’s specialists,
centering around one or two journal articles. Copies of journal articles
will be provided ahead of time and are available by calling our office. Two hours of continuing education credit is available for this format!
Upcoming Round Table Articles
Evaluation of plasma lactate concentration and base excess at the
time of hospital admission as predictors of gastric necrosis and
outcome and correlation between those variables in dogs with
gastric dilatation-volvulus: 78 cases (2004-2009), Beer, et al,
JAVMA, vol. 242, (1) 2013, pp. 54-58.
Long-term functional outcome of tibial plateau leveling osteotomy
versus extracapsular repair in a heterogeneous population of dogs. Nelson et al, Veterinary Surgery 42, 2013 pp. 38-50.